Northern Nights Sleep Disorder Centre

Getting Started on pressure therapy for sleep apnea

All the positive airway pressure machines take normal air and compress or pressurize it. You breathe that pressurized air via a mask that covers your nose, or your mouth and nose. The pressurized air keeps your throat stable so it won’t vibrate or collapse: it should stop snoring and apnea.
CPAP stands for Constant Positive Airway Pressure and delivers a constant steady pressure. It is the treatment used most often.
BiPAP delivers 2 pressure levels - a lower pressure when you breath out and a higher pressure when you breathe in. It is useful for occasional people who need very high pressure to keep the airway open. You have to meet some specific rules for Ontario to fund BiPAP. If you need BiPAP the physician at NNSDC will discuss it with you.
APAP and VPAP stand for Autoadjusting or Variable Positive Airway Pressure. These systems are supposed to raise and lower the pressure automatically to give you only the pressure you need. Although they are useful in people with big differences bwetween the pressure they need on their backs compared to their sides, or between REM and other stages of sleep, they don't work well for everyone. Also they are more expensive and complex machines. You must meet some specific rules for Ontario to fund APAP. If you need APAP the physician at NNSDC will discuss it with you.
You will be given a prescription for the pressure and pressure delivery method that worked the best for you, and mask that worked the best for you, during your night starting pressure therapy in the sleep lab.

Why should you use CPAP or another pressure therapy?:

Sleep apnea gradually causes: high blood pressure; increased risk of heart attack and stroke; decreased memory; increased accidents; impotence; drowsiness and decreased energy. Not everyone is affected the same way, but the worse the apnea, the bigger the risks, and using CPAP decreases those risks.

What happens if you don't wear it?:

It generally isn’t immediately dangerous if you don’t use CPAP. Your snoring and other symptoms will come back, usually within a few nights, and the longer you aren’t on therapy the more long term risk you have.
Some people with severe sleep apnea notice feel terrible when they stop CPAP, but they aren’t worse than they were, they are just returning to where they were before treatment.

Will you have to use CPAP forever?

CPAP doesn’t cure sleep apnea. The pressure keeps your throat from vibrating or collapsing when you sleep. Using CPAP doesn’t make you dependent on it and when you sleep without it, everything just goes back to the way it was. CPAP is the current best treatment for sleep apnea, and if you can use it, you should keep using it until there is a better treatment. To get the long term benefit you need to wear it at 5 hrs a night at least 5 nights a week, but it works best if you wear it whenever you sleep.

Where can you get a PAP system to use at home?

Two regional companies supply CPAP systems: Medigas and Shoppers Home Health Care
They both have offices on the same floor as the sleep lab, just outside our main office door. They are open at 7 a.m. and you can get set up right away. It takes about 30 minutes.
You can also call for an appointment at their main offices:
Shopper’s Home Health Care 285 Memorial Ave. (at John St) 345-6564
Medigas 290 South Water Street (at John St) 345-8288
Although we work with both companies to try and deliver optimal service to you, NNSDC has no commercial connection to either company.

How much does CPAP cost?

The cost to you is usually ~$260-650. Complete details are available from the suppliers.
The cost of a CPAP system is partly paid by the Ontario Assistive Devices Plan (ADP) and partly by you, or by your supplemental or disability health insurance plan.
Your share of a brand new standard system with a standard nasal mask is ~$260. Special masks and special CPAP systems typically cost $250 – 400 more. Ask SHHC or Medigas for details.
Most supplemental or disability health insurance plans pay the costs not covered by ADP.
People over 65 are not covered for the full cost of a system unless they have extra insurance.
The CPAP companies may offer you other services at an additional cost, for example to allow you to try different systems and masks as you get started on CPAP.

How does the supplier know what pressure and what mask to give you?

You will get a prescription for the recommended pressure and a recommended mask after your study

In progress

More sections to come soon including: How to actually start using it? Where should you put the machine? What you should do every morning. How do you keep it clean? How do you adjust the pressure? What is 'ramping'? What if the power goes out? - and - and entire page on solutions to common problems.... it is all coming to a page near you!